Individual
CONRAD ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12 SOUTHERN AVE, BOSTON, MA 02124-2012
(617) 708-0870
Mailing address
12 SOUTHERN AVE, BOSTON, MA 02124-2012
(617) 708-0870
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/14/2020
Last updated
11/14/2020
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